At noon her patient looks calm and peaceful, swathed up to his chin in the Bair Hugger blanket. There's at least a litre and a half in his catheter bag, but the most recent amount in the hourly-measuring compartment seems to be trailing off to something more reasonable, and is back to a beautiful pale yellow rather than almost-clear. His heart rate spools out on the monitor at a perfect 62 beats per minute, with only the occasional ventricular beat disrupting it. His blood pressure is at 122/67 and only fluctuating within a 5-point range. His temperature is 35.5. 

Marian feels kind of bad about waking him when he looks so comfortable. She's just going to...stand here, at the foot of the bed, for a minute or two, and bask in how nice and happy and good all those numbers are. It's one of the best feelings, when that happens. Almost as good as getting a recovering patient up out of bed for the first time. That's almost certainly not going to happen with this guy today, but maybe tomorrow, if she gets the same assignment again... 

His eyelids are a little puffy from all the fluids, but other than that, Marian's finely-honed nurse instincts are informing her that he looks great. Good colour, he's breathing on his own above the ventilator rate, his sats are 100% on just 30% oxygen and he probably doesn't even need that much. 

The magnesium and phosphate bags aren't quiiiiite empty yet, so she might as well do an actual thorough noon assessment and then pull the labs after. 

She taps his shoulder, taking his hand. "Hey. It's Marian again." Wow, not knowing his real name is getting more awkward as time goes on. "Can you open your eyes?" 

Ma'ar was fast asleep, after a half-hour of peace and quiet and the brightest lights above him being finally switched off. He startles awake, disoriented, and reflexively yanks at the restraints before he remembers, and goes limp. 

It's her again, at least, and he can't sense anyone else in the room with her, or hear any other voices in earshot. Which...might be a rare opportunity? He opens his eyes and tries to look around as well, but he's still seeing double and everything more than two feet away from his nose is too blurry to make out. There's no other movement but he can't say for sure there's no one within line of sight.

He squeezes Marian's hand back, just in case that's one of the things she asked him to do and he missed it. 

She didn't, but Marian beams at him anyway. "That's really good! You look way better. Are you feeling better?" 

Well, Thoughtsensing is hurting less, at least, and doesn't feel quite as tiring to maintain. Ma'ar tries bending his leg, and concludes that he's not as hopelessly weak as before. He nods. 

"Good! I'm not surprised you feel better, there's so much less wrong with you now. You - hmm, I don't know how well you remember? But you came in really cold. You fell through the ice in the river. That's why we have the hot-air blanket on you, right? And now you're most of the way to being warm again. Does that make sense?"

Marian is trying to remember to speak very slowly and enunciate clearly, to give him as good a chance as possible of catching what she's saying. She remembers very well how hard it was in nursing school to understand the Quebecois-raised nurses jabbering away. 

Ma'ar feels somewhat clearer-headed than before, though he still has to fight the tide of drowsiness tugging him down. And the thought-concepts underlying her words are simpler, this time. When she asks if he understood, he nods. 

...He even tries to dig further at her other surface thoughts, to see if he can glimpse any useful context on where he is and what they're planning to do with him next, but that's a much harder challenge to begin with, and right now Marian's thoughts seem mostly focused on him. She seems to be feeling very pleased with herself and...proud? Of him? For, what, the fact that a warm blanket makes him warmer? Ma'ar isn't sure what to do with that. 

He seems noticeably less out of it, Marian thinks. Maybe it makes sense, if the hypothermia and screwy electrolyte levels were contributing to his confusion before. He still looks a bit loopy, his eyes wandering a bit, clearly it's taking him effort to focus on her - that'll be the midazolam. 

"Right. Another thing we've been doing is - okay, so the amount of some minerals - important things - in your blood, was wrong. So we're injecting those into you, into this big IV in your neck," she taps it, gently, "but we need to do it slowly or it could hurt you. I bet you're going to keep feeling better and better as we fix all of that."

Marian doesn't have the slightest idea what a phosphate level of 0.9 feels like but almost certainly some variety of 'terrible'. And low sodium causes...headaches? She's not even sure why she knows that, but it seems worth checking. 

"Do you have a headache right now?" 

Not nearly as much as before, it's faded to a dull background ache and only throbs a little harder when he uses his purely-receptive Thoughtsensing. Ma'ar isn't sure how to convey that, though, so he just nods, then - tries to do a sort of shrug, with the limited motion he has, and attempts a crooked smile. 

That comes across pretty clearly! Maybe because it makes medical sense. "Headache yes, but it was worse before?" She smiles at his nod. "Well, I can probably get you some milder painkillers that won't make you sleepier. Sound good?" 

(Nod.) 

"Okay, good. Right now I need to have a look at you. Nothing that hurts, but I do want to turn you again and look at the skin on your back. If you think that's going to be uncomfortable, I can give you extra medicine for it?" 

Ma'ar is confused. (Marian's thoughts here are more complicated than her words, jumping between concepts she's familiar with - hypothermia means vasoconstriction means bedsores, she remembers him falling, he could have abrasions or bruises and there's a mandatory admission assessment which she has totally not done yet and she feels bad about that.)

He does his best to piece it together. She isn't trying to hurt him but she needs to - look over injuries he already has? And she's worried that might be painful. Ma'ar, having been injured before, can't disagree. 

She's already been giving him some kind of pain-drug - he can glimpse that in her thoughts, when she asks about giving him extra - so that's why he's so drowsy. He isn't sure how he failed to notice - the part where she was explaining something and pointing out his neck was way too confusing and bizarre to follow when he's this groggy, but maybe related? 

This probably will hurt, but he needs to be clearheaded later, so he shakes his head at her question. 

"If you're sure. Uh, I'm going to listen to your lungs and belly and do some other things first, and then I'll grab someone else to help you turn on your side, I think you're still not strong enough for that." Aaaand if she has to untie him, she really wants a second person there. Just in case. 

She's being appropriately cautious, which is going to make this harder. 

Ma'ar lies still and compliant while she reaches under the blanket - he can't really see what she's doing - and presses something cold and circular against his chest, then his stomach, and then walks around the bed and lifts the blanket to look at his legs and feet. 

He tries valiantly to stay awake so he can plan ahead a little, but he keeps losing his train of thought. He does manage to eke out that he probably won't be able to walk unaided for a while, let alone run. And he feels drained, the familiar hollowness inside him; he can't rely on being able to Gate either, even if he could manage, it would leave him incapacitated. And anything precise is going to be an issue while he's drugged, which rules out compulsions.

Staying awake is hard and his headache is worse again. Ma'ar attempts to make a mental note for when he next wakes. Escape plan. 

Marian tries not to hiss out loud at his feet, which are a mess. Good pedal pulses, at least, and the skin is cool but not cold, and the capillary refill in his toes is only moderately delayed. But the soles of his feet are, one, blackened with road-grit, and two, cracked and abraded. It's not just dirt, there's dried blood as well. He must have been walking barefoot for a while. He's lucky to have escaped frostbite. 

She makes sure his restraints are still firm, and then goes to find another nurse willing to trade help with turns. 

Marian's voice doesn't quite pull Ma'ar out of his doze, but the cold air on his skin, and the hands gripping his shoulder and hip to roll him on his side, do.

It hurts less than he expected, though, given how incapacitated he remembers feeling. His back feels tender and bruised where Marian touches it, but her hands are gentle, and it's tolerable. And, mercifully, she's not at it for long, only thirty seconds or so. 

"Definitely got lots of bruises. Some abrasions but they're superficial." Marian is talking half to herself and half to Anne-Marie, not really addressing her patient, who seems to be out again. "Don't think any of it needs dressings. Skin feels warm. He wasn't hypothermic for that long and he'll probably be mobile pretty soon - I'm not sure exactly what to put for the admission Braden scale... Oh and I don't even know what to put down for his feet. Want to have a look?" 

Anne-Marie looks, then winces. "Oof. Poor guy!" 

"Abrasions or lacerations? It - seems somewhere in between, I don't think there's an option for 'cracked foot calluses'. I was thinking I'd clean him up gently with soap and water and then I'll be able to see better what's under all that muck." 

     "Eh, seems fine. Can we go do my folks now?" 

Marian frowns. "I had noon labs. Can I send those off and come find you? It'll be quick." 

     "Yeah, sure thing." 

She draws the labs, and then putters, bumping the norepi down to 4 ml/h - unbelievable! - and, just because she can, dropping the midazolam to 1.5 mg/h. If he's agitated at any point she'll switch him to propofol, but he seems calmer now. She suspects it's because he's less disoriented when he can better follow what's happening to him. Which has her kind of tempted to just get him off the sedation entirely, and then go announce to Dr Prissan as a fait accompli that he's ready for extubation.

If she can get him entirely off pressors, Dr Prissan will have to acknowledge that he's hemodynamically stable, but accomplishing that unlikely on propofol, given how sensitive his blood pressure is to it... 

Still musing, she sends all her blood work, including a repeat blood gas that someone snuck in there when she wasn't looking and that requires an extra trip to the supply room. She goes off to help Anne-Marie. 

For the next indeterminate length of time, Ma'ar floats through haze, sometimes interrupted - but it's an increasingly shallow haze. The downside is that various sources of discomfort are bothering him more; the stupid tube shoved in his mouth and down his throat is especially unpleasant, it's a constant tickle like he either needs to cough or throw up, piled on top of the frustrated ongoing and thwarted desire to sneeze. 

Marian, at one point, comes back in and says she has to wash and bandage his feet. Ma'ar acknowledges this with a nod and lets her do it. It's not unpleasant, which is a nice change. 

The lab doesn't call this time; Marian sees the results the next time she sits down to chart. It's definitely better! Sodium is up a touch, to 130. Potassium up to 3.2, still technically low but not critically so, and the third bag wasn't done yet when she drew the blood. Phosphate and magnesium are both just a touch below the normal reference range, no longer critical. The blood gas is perfect in every way except for being a lot higher than necessary on the partial pressure of O2.

She tracks down Dr Beckett, currently taking a break before they finish rounds on the last three patients at the opposite end of the unit, and reads off the labs. "Should we give him some more? Pharmacy recommended getting him to high-normal and he's still low." 

Emmy rubs gritty eyes. "Um, that...seems reasonable. Why don't you ask them for dosing advice, I don't know if we want to supplement the same dose again or a smaller one. What's his temp?" 

"He's up to 35.9! I should probably actually turn off the blanket first, but I'm tempted to wait until he tells me he's too hot." 

"Whoa, he's communicating with you?" 

"Seems to be managing better, yeah! It might just be that he's less confused just because his numbers are all better now. Oh, and I've weaned him down to two on the norepi, and 1 mg an hour on the midazolam, he seems a little uncomfortable but calm." 

"You didn't end up starting propofol?"